Cabrera de León Antonio, Rodríguez Itahisa Marcelino, Gannar Fadoua, Pedrero García Arturo J, González Delia Almeida, Rodríguez Pérez M Del Cristo, Brito Díaz Buenaventura, Alemán Sánchez José Juan, Aguirre-Jaime Armando
All authors are with Unidad de Investigación de Atención Primaria y del Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Canary Islands, Spain. Antonio Cabrera de León is also with Área de Medicina Preventiva y Salud Pública, Universidad de La Laguna, La Laguna, Spain.
Am J Public Health. 2018 Aug;108(8):1091-1098. doi: 10.2105/AJPH.2018.304346.
To analyze mortality in Spain and the United States before and after these countries implemented divergent policies in response to the financial crisis of 2008.
We examined mortality statistics in both countries in the years 2000 to 2015. Spain started austerity policies in 2010. We compared differences in mortality ratios, on the basis of trends and effect size analysis.
During 2000 to 2010, overall mortality rates (r = 0.98; P < .001; Cohen's d = -0.228) decreased in both countries. In 2011, this trend changed abruptly in Spain, where observed mortality surpassed expected mortality by 29% in 2011 and by 41% in 2015. By contrast, observed mortality surpassed expected mortality in the United States by only 8% in 2015. As the mortality statistics diverged, the effect size greatly increased (d = 7.531). During this 5-year period, there were 505 559 more deaths in Spain than the expected number, while in the United States the difference was 431 501 more deaths despite the 7-fold larger population in the United States compared with Spain.
The marked excess mortality in 2011 to 2015 in Spain is attributable to austerity policies.
分析西班牙和美国在针对2008年金融危机实施不同政策前后的死亡率情况。
我们研究了2000年至2015年这两个国家的死亡率统计数据。西班牙于2010年开始实施紧缩政策。我们基于趋势和效应量分析比较了死亡率比率的差异。
在2000年至2010年期间，两国的总体死亡率均下降（r = 0.98；P <.001；科恩d值 = -0.228）。2011年，西班牙的这一趋势突然改变，2011年实际死亡率超过预期死亡率29%，2015年超过41%。相比之下，2015年美国实际死亡率仅超过预期死亡率8%。随着死亡率统计数据出现差异，效应量大幅增加（d = 7.531）。在这5年期间，西班牙的死亡人数比预期多505559人，而美国尽管人口是西班牙的7倍，但死亡人数比预期多431501人。
西班牙在2011年至2015年期间明显的超额死亡率归因于紧缩政策。
